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Routine screening for anaemia during pregnancy and after childbirth is essential for preventing maternal illness and death, yet its clinical delivery remains inconsistent worldwide. A scoping review of 116 studies evaluated screening practices, barriers, and strategies, contrasting regions with high and low anaemia prevalence. Guidelines consistently advise universal screening in pregnancy alongside selective postpartum checks, utilising automated or point-of-care haemoglobin tests and iron evaluations. However, testing coverage is notably lower in areas with high anaemia rates. Key operational hurdles include shortages of screening supplies, which represent the primary barrier in high-prevalence settings, whereas supportive supervision acts as the main facilitator. Interventions focused heavily on training healthcare personnel to use point-of-care diagnostics, which showed strong feasibility. Standardised clinical guidelines and sustained operational support are required to improve testing rates and address postpartum gaps.
Anaemia during and after pregnancy can cause severe health complications for mothers and infants. Identifying why screening fails to reach women, particularly in high-prevalence regions, helps healthcare programmes address specific bottlenecks. Understanding that supply shortages hinder care while staff training and supportive supervision improve delivery enables health systems to design more effective maternal health interventions.
The findings point to direct opportunities for developers and suppliers of point-of-care haemoglobin diagnostic devices and testing consumables. Healthcare providers and maternal health programmes in high-prevalence regions are the primary end users. Point-of-care diagnostic tools are already applied and tested in the field, but scaling them requires addressing supply chain shortages and delivering structured healthcare worker training packages alongside the hardware.
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Background Screening for anaemia in pregnancy and the postpartum period is an important component of maternal care to prevent associated morbidity and mortality. However, the implementation of routine screening practices for pregnancy‐related anaemia remains variable, inconsistent, and suboptimal. This review aimed to synthesise the literature on practices, facilitators, barriers, implementation strategies, and outcomes of routine screening for pregnancy‐related anaemia. Methods This scoping review followed the JBI methodology and PRISMA‐ScR checklist with a comprehensive systematic search of seven academic databases (PubMed, EMBASE, Scopus, CINAHL, Web of Science, Global Index Medicus, and African Journals Online) and selected grey literature sources. Retrieved citations were screened, and relevant references were assessed for eligibility. Articles included were analysed qualitatively and presented descriptively by concept, comparing settings with high and low prevalence of anaemia in pregnancy. Results We identified 9497 references and included 116 articles in this review. Clinical practice guidelines recommend universal screening for anaemia during pregnancy and selective screening in the postpartum period using automated or point‐of‐care haemoglobin testing and iron studies, with variations in screening frequency and timing. Screening coverage for anaemia in pregnancy was lower in high‐prevalence compared to low‐prevalence settings. Effective supportive supervision was the main facilitator of anaemia screening in pregnancy, while lack of screening materials served as the main barrier, particularly in high‐prevalence settings. Training health workers on point‐of‐care testing in high‐prevalence settings was the most common strategy used to improve the implementation of routine screening for anaemia in pregnancy, and its feasibility was the most studied implementation outcome. Conclusion Implementing routine screening practices for pregnancy‐related anaemia in all settings will benefit from harmonised clinical practice guidelines. Efforts are required to address implementation challenges and move from the early phase of implementation towards sustainability. Future research should aim to fill the knowledge gaps in implementing anaemia screening, particularly in the postpartum period.
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DOI: 10.12688/verixiv.1266.1
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